title: Metastatic Merkel cell carcinoma (MCC) of pancreas and breast: a unique case.
abstract: Merkel cell carcinoma (MCC) is a rare potentially fatal skin tumor affecting older and immunosuppressed individuals. It is highly malignant with high rates of metastasis and poor survival.We present a case of a 67-year-old woman with a palpable mass in the upper abdomen. An abdominal CT revealed a mass in the tail of the pancreas. Two weeks before, lumpectomy of a 3.5 cm tumor of the left breast had been performed. Histology showed a primary neuroendocrine carcinoma of the mammary gland. The patient's medical history was significant for a 0.7 × 0.9 cm MCC removed from her left forearm 2.5 years ago. There was no evidence of vascular involvement or peritoneal disease and by all criteria was resectable. A somatostatin receptor scintigraphy showed an enhanced uptake in the pancreatic tail region. The tumor was immunohistochemically strong staining for synaptophysin and CD56. The diagnosis of a metastatic-MCC in the tail of the pancreas was made. Further histological investigation of the prior removed neuroendocrine breast tumor and the MCC of the left forearm confirmed neuroendocrine origin and identical histology to the previously resected MCC of the left forearm. In this article, we aim to highlight that MCC has the potential to spread even in unusual organs, such as pancreas or breast, and therefore a diligent follow-up should be applied in patients with MCC.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Hufelandstr, 55, Esse 45122, Germany. svernadakis@yahoo.com.
authors.forename: Spiridon
authors.initials: S
authors.lastname: Vernadakis
authors.forename: Demetrios
authors.initials: D
authors.lastname: Moris
authors.forename: Agnes
authors.initials: A
authors.lastname: Bankfalvi
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Makris
authors.forename: Georgios C
authors.initials: GC
authors.lastname: Sotiropoulos
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D019002:CD56 Antigen / Q000378:metabolism; D015266:Carcinoma, Merkel Cell / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D011379:Prognosis; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D016708:Synaptophysin / Q000378:metabolism; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D019002:CD56 Antigen; C522918:NCAM1 protein, human; C569014:SYP protein, human; D016708:Synaptophysin